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Mental health in South Korea

Mental health in South Korea

[Editor's Note] It’s truly an unfortunate phenomenon that so many of us choose to avoid openly talking about uncomfortable topics. But dealing with our mental health is an inescapable part of being human, despite our possible aversion to acknowledging that we may be facing issues, struggles or emotions that need to be addressed. In today’s guest post, Rob discusses the stigma and shame surrounding mental illness, both in South Korea and Western societies.  

By Rob Defina

Last September Korea experienced a series of ongoing earthquakes. The first took place on September 12th with a magnitude of 5.7. This quake, while globally a murmur, was considered to be Korea’s largest earthquake on record (which only dates back about 50 years). This occurrence, coupled with rising tensions with North Korea resulted in me experiencing a two week-long hyper anxious period. I was a mess, honestly.

I went to see a psychiatrist a couple weeks after the first earthquake and by then I was already feeling better, but an education in mental health and psychology told me that even if I was feeling better those emotions would not permanently recede so quickly. The psychiatrist told me I was the fifth person that day to come in to discuss post-earthquake anxiety in his office.

It was then that I wondered how many of those people told the honest truth about where they were going that day. Or how many of those people discussed their therapy session with their spouses or families afterwards. I was nearly certain that only one of them would write an article about it and not be concerned with judgment. Once again, my education in psychology really has formed inroads in my understanding of human reactivity and shame associated with mental health. And while we, as Canadians (and Americans) tend to look at the supposed flaws of Asian countries and laugh off their ignorance – when it comes to mental health, we aren’t as progressed as we think we are.

Korean Perspective

During the first few months of my time here, a popular news story was often talked about by my co-workers. A man who decided to commit suicide jumped out the window of an apartment building and unfortunately landed on another man who was walking with his family in the parking lot. Both men were killed.

The sentiment in the office was always “Oh that poor family” and rightfully so – the secondary victim of this suicide was in no way related to the primary victim and was in absolutely the wrong place at the wrong time. When asking about their thoughts on the man who jumped, repeated pity about how “crazy” he must be and how “he was sick” began to turn my stomach. While the tragedy on the news was seemingly in favor of the father who was killed, an analysis of the mental health of the jumper was nowhere to be found in the media nor in the individual reactions of the people. There was someone to blame and it’s a tragedy that couldn’t have been prevented… right? Or could it have?

When it comes to the elderly, South Korea has the highest suicide rate worldwide.

When it comes to the elderly, South Korea has the highest suicide rate worldwide.

South Korea has the highest suicide rate of any developed country on Earth, with a statistic stating that 1 in every 3450 people (over 13,000) will commit suicide yearly. Another surprising detail is that this rate is high because of the amount of elderly people killing themselves. More than half of Korea’s elderly live below the poverty line, a direct after-effect of their assets being lost in the Korean War and thus a complete and utter restart of their lives and careers without an education suited for the booming world around them. Pair this with the fact that suicide is the leading cause of death in people aged 10-39, the numbers become less surprising. The factors affecting younger people tend to be related to the competitive education system, financial instability and even, believe it or not, a harsh response to the suicide of celebrities (a phenomenon noted around the world).

The gravity of this is unimaginably heavy, a crushing weight on a society so determined to move forward that it leaves so many members behind. This is manifested as a laugh-it-off method, similar to the way they laugh off the threat from North Korea. The students at my school, despite being shown videos about suicide prevention, continue to joke about suicide in their classrooms and the teachers laugh along with them. The severity of the situation is never addressed. In true Asia-Pacific cultural fashion, the truly difficult, human things are swept under the rug. A veil of superficiality and emphasis on money and wealth, celebrities and fame, all amount to a terrifying result to those who feel lesser in their society, who feel unsuccessful and who feel like they will gain nothing in their lifetime.

The disastrous nature of such a societal construction can be explained by understanding the nature of mental health here and its suppression. I took it upon myself to use one of my weekly teacher’s classes to teach my co-workers how to talk about mental health in English. Notably drastic mistakes included the Korean language giving Bipolar Disorder and Schizophrenia the exact same word; assuming depression is just ‘being sad all the time’ (this included the examination of a student who they all said has depression but has never been diagnosed by a professional); and the excuse that any child acting out in class suffers from ADHD. By their observation, depression was highly common in South Korea, especially in older women whose children have left home and whose lives suddenly lose meaning.

There are an abundance of reasons why their conclusions are drawn too quickly, why they diagnose each other from afar without truly understanding the derivative concepts associated with mental illnesses and their diagnoses. In the end though, there is no emphasis on staying healthy in these matters. The encouragement to see a psychiatrist is less likely to be associated with the positive healing process that one would get from a doctor but instead is a result of shaming someone. The tone at which “he should see a psychiatrist” is delivered more in the vein of ‘someone needs to do something about him’ rather than ‘I’m concerned for his wellbeing’.

It is for this reason, known as shaming, that less people are likely to seek professional help and if they do they are unlikely to ever speak about the matter, which is more likely to lead to further issues. According to the WHO, in South Korea, only 15% of people diagnosed with depression get professional attention. That leaves 85% of those afflicted by depression to fight with it on their own in a society that laughs off suicide and puts no emphasis on the betterment of oneself through open dialogue. And who knows how many more cases go undiagnosed in the shame society.

In general, I have noticed a conversation regarding anxiety, fear and emotion is always curt and quick. The dialogue that followed the major earthquake was simply met with a few worried comments but never any serious follow-ups. Even while I was going through my anxiety and felt open enough to express it to a few of my co-workers, there was little that was said in an effort to comfort me. Truly, every dialogue that came up on the matter was quickly diffused – the avoidance of the uncomfortable topics is astounding and almost doused in such a unified manner that you are instantly reminded that in South Korea you will be dealing with deeper wounds on your own.

One co-teacher of mine took it upon herself to continuously make jokes to me about the severity of the earthquakes, saying that I should “probably go home” for my safety. Even those who expressed their fears with me made a point to change the conversation instantly. South Korea has become a clear example of how, if you are not used to talking about your feelings, you will likely continue to be uncomfortable doing so as an adult.

Western Perspective

I often find myself having a difficult time with these blogs to not make it seem as though the Western Perspective section hops up on a high horse and guffaws at the slow pace of the South Korean mentality. This time, however, I must admit that while writing the above Korean Perspective, it almost felt as though I were writing about the perspective back home as well. While change is occurring in many positive ways in regards to mental health, there is still a plentiful amount of shame that is dealt around in our Western societies.

I have an abundance of friends who would likely support the notion of seeing a mental health professional in times of need and others who would shrug their shoulders and say ‘what’s the point?’ The truth is, as long as someone feels they are getting something out of therapy, then any shaming by others likely comes from an inner insecurity or is a conditioned notion that speaking about your problems solves nothing. When it comes to mental health though, I’ve learned that speaking is taking action and sometimes when it comes to the way we feel, our words speak louder than our actions.

I truly believe those misunderstandings noted in my teacher’s class could be applied to the general Canadian population. If I asked someone without an education in psychology to tell me the difference between Bipolar disorder and Schizophrenia it is likely that they would have a difficult time. It’s also quite common for people to misuse the word depression when trying to exclaim their feelings of sadness, not realizing that depression is, in fact, a loss of affect and a lack of emotion altogether, not just an extreme feeling of sadness. And yes, the unofficial verbal diagnosis of ADHD is occasionally frequented. ADHD, standing for Attention Deficit Hyperactivity Disorder, is marked by a hyperactive disposition as well as a lack of focus. Plenty people mistake angry outbursts and misbehavior as a manifestation of ADHD in South Korea AND in Western countries. Another extremely common one is misusing the diagnosis of OCD (Obsessive Compulsive Disorder) as a trait of extreme organization, instead of the obsessions one might have and the resulting compulsive behaviors they perform to quiet their thoughts.

The misconceptions we have about mental health and the disorders associated with it are a direct cause of the under-education we’ve received in our schooling. Health class in my high school barely scraped the surface of sex ed (thanks, Catholicism) let alone the health associated with our psychology.

Contributing factors to Western society’s aversion towards mental health conversations has a lot to do with the premise of masculinity, a damaging notion that has led to many issues in our Western society, especially in recent years. The notion that men feel less than women and are then less likely to express them explains why, in Western countries, suicide in adolescents is two times more likely to affect males than females. Even more so, the influx of immigration and multiculturalism is also a factor in predicting mental health instability, as studies have found that those who newly immigrate to a place are more vulnerable to incidences that would damage their state of mind (thank you for the validation!). As well, whereas in Korea there is more trust within the people, multiculturalism can sometimes lead to subtle mistrust between people based on racial and religious divide, so much so that anxiety might be a little higher in public places or certain neighborhoods.

Regardless of what may contribute to the high rates of mental illness in Western countries, the real change needs to be assessed at the diagnosis and treatment level, but first the awareness must be met. The discomfort associated with our own thoughts and feelings likely contributes to the lack of change in these instances. But to be frank with you I would much rather spend an hour talking out my problems than pulling down my pants and being told to cough twice while someone holds my private parts for even a moment (sorry for the image). But maybe that’s just me.

While this example is a joke in nature, it does show us that what is normal and what we deem acceptable in our culture is truly a matter of what we’ve been told is normal, natural and totally okay. So why haven’t we been told that talking about our problems is okay? Who decided that was of least importance?

The shame that is tethered to our unappealing emotions and struggles is truly the weight that carries us down paths that only worsen our problems. When we are not given the tools to properly assess ourselves and work through our deepest unsettling feelings, we get lost in battles of suppression with ourselves, burying things deeper and deeper because we convince ourselves that speaking about these things is not helpful to us or others around us until they become too much to handle.

While a perfect world certainly does not exist, it is my belief that a world where people become more comfortable with discussing their problems is truly a place where people can feel safer and more comfortable with themselves. I don’t know if any place on earth is at a point where the mental health of its citizens is taken with the utmost care (and if it exists please let me know so I can move there), but there are definitely more things we could be doing as individuals to allow this to develop in the right direction. It doesn’t mean forcing people to talk about their problems when they don’t want to, it just means creating an open channel with ourselves and our circles, our friends and family, that honesty comes first and that treating each other without judgment is a sign of loving one another. It comes from our governments telling us that our mental health is valid, just as our physical health is. It comes from the recognition that the inner battles we face end up being projected onto one another and those projections dictate how we behave in our day to day lives. And it comes from the understanding that every person we hold dear will always have issues and supporting one another is truly all we can do… which is why shaming one another or speaking ill about mental health practices is a truly terrible affliction.

My friend and I recently shared dessert here one night in Korea, just chatting away about our feelings. After venting about something he was feeling he thanked me and said “a problem shared is a problem halved.” Apparently, I’m not with the times because I’ve never really heard that before, but truly it describes the importance of that reciprocal relationship.

Thank you for letting me halve my post-earthquake anxieties.

What have you been going through lately?

“The truth is that telling heals. Not just once. But as a way of being that clears the heart of its debris.” -Mark Nepo

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Viv Delgadillo & Matt Mateiescu [VM Creativ]: Photographers

Viv Delgadillo & Matt Mateiescu [VM Creativ]: Photographers

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